Are you experiencing changes in your health that concern you? Do you think you have diabetes? Learn about the types of diabetes, symptoms, diagnosis and treatment.
How do you know if you have diabetes? If you are asking yourself this question, something has caused your concern. Maybe you have a friend who was recently diagnosed. Perhaps diabetes runs in your family, or your doctor has told you that you are at risk for pre-diabetes. Maybe you are noticing changes in your health that concern you.
Whether you have diabetes or not, you have taken an important first step, which is asking questions and seeking answers -- here’s some info to get you started.
What is Diabetes?
According to the Centers for Disease Control and Prevention, in 2018 an estimated 34.2 million people in the United States were living with diabetes (diagnosed or undiagnosed). So, what is diabetes? Diabetes mellitus is the scientific term for diabetes and it refers to a group of diseases that are related to how your body uses glucose.
When you eat, your body starts working to turn your food into fuel. Food is digested with the help of hormones and enzymes to become the energy your body needs. Glucose is the main energy source for your body, but it needs help getting into your cells. Insulin is a hormone made in the pancreas that allows your cells to use glucose. Insulin also regulates the amount of glucose in your blood. Diabetes happens when your body cannot efficiently produce or use insulin to convert glucose into energy, causing a buildup of sugar (glucose) in your blood.
There are several types of diabetes. The underlying cause of diabetes is different for each type, but all types of diabetes can cause a buildup of sugar in your blood that can cause serious health problems if not properly treated. Let’s review some of the most common types of diabetes.
Type 1 Diabetes
Type 1 diabetes is an autoimmune condition that causes your body’s immune system to attack and destroy the cells in your pancreas (beta cells) that produce insulin. Type 1 diabetes is less common than type 2 diabetes and is thought to be caused by a combination of genetics and possibly some environmental factors.
Although type 1 diabetes can occur at any age, it is most commonly diagnosed in children and young adults.
Type 2 Diabetes
For people living with type 2 diabetes, the body does not produce enough insulin or does not use it efficiently. This is the most common form of diabetes and is caused by multiple factors such as family history and genetics. Risk of developing type 2 diabetes can increase by factors such as obesity and lack of physical activity.
Type 2 diabetes most often occurs in adults. Sometimes, people with type 1 diabetes are misdiagnosed with type 2 diabetes at first. Misdiagnosis normally occurs when a doctor diagnoses type 2 based on glucose and A1c lab results, paired with the age of the patient. The patient will be sent home with a glucose meter and a prescription for lantus or metformin, and weeks later when symptoms don't improve, the patient is re-evaluated and re-diagnosed with the proper diagnosis.
The takeaway? When you go in for a diabetes diagnosis, it’s worth it to note additional symptoms and circumstances, and ask if a c-peptide or autoantibody test would be useful. If you are an adult and have symptoms of diabetes, make sure you discuss these additional lab tests with your doctor to confirm diabetes type.
People who have prediabetes have a higher than normal blood sugar level, but not high enough to be considered type 2 diabetes. People who have been diagnosed with prediabetes are more likely to develop type 2 diabetes, but it is not inevitable. Changes in lifestyle like eating healthy foods, exercising, and staying at a healthy weight can help bring your blood sugar back to normal levels and keep a type 2 diabetes diagnosis at bay.
The cause of gestational diabetes is unknown, but the common mechanism for it comes from hormonal changes during pregnancy that block insulin action, causing insulin resistance for the mother. Gestational diabetes often goes away after the baby is born. Many times, it has no symptoms, which is why women get tested at the appropriate time during pregnancy.
Symptoms of Diabetes
Now that you understand the different types of diabetes, let’s review the symptoms of diabetes. Remember, only your health care provider can diagnose diabetes. If you have one or more of the symptoms below, it is best to see your doctor for further help.
Prediabetes and gestational diabetes don’t usually have any obvious symptoms. These conditions are diagnosed through routine blood tests performed by your doctor during checkups.
Type 1 and type 2 diabetes share several symptoms even though their severity and treatment can be very different. Symptoms of type 1 diabetes usually develop quickly, often over a period of weeks. Early stages of type 2 diabetes can have no noticeable symptoms. Blood sugar checks should be part of yearly wellness exams to detect health concerns including diabetes if you are at risk or notice symptoms.
The most common symptoms of undiagnosed type 1 and type 2 diabetes are frequent urination, excessive thirst, and excessive hunger/fatigue.
Frequent urination – When your kidneys are working hard to filter out excess sugar from your blood you usually have to urinate more often. Health care providers call this condition polyuria.
Excessive thirst – An imbalance in part of your body causes imbalances in other areas. Because your kidneys are working hard to filter out excess sugar from your blood, you feel very thirsty and dehydrated. Dry mouth, irritated eyes, and uncontrollable thirst happen when your kidneys are using lots of water in your body to filter out excess sugar from your blood. Health care providers call this polydipsia.
Excessive hunger/fatigue – Like excessive urination and excessive thirst, excessive hunger and fatigue are closely related. If you are living with diabetes, it is difficult for your body to convert glucose from your food to energy. Lack of available nutrients in your system causes you to feel the need to eat constantly. Health care providers call this polyphagia. Feeling tired or fatigued goes hand-in-hand with feeling hungry. If your body is not getting enough nutrients from food, you feel extremely tired, even if you are getting a good night’s sleep.
Other symptoms of diabetes include:
Blurry vision. High blood sugar can cause damage to the vessels in your eyes and cause blurred vision.
Cuts and bruises that are slow to heal. Increased blood sugar affects your immune system and circulation, which makes it harder to heal from injuries.
Unexplained weight loss. If you aren't getting enough nutrients from your food, you can lose weight even though you are eating normal amounts of food. This symptom is most common leading up to a type 1 diabetes diagnosis due to diabetic ketoacidosis (DKA).
Tingling, pain, or numbness in your hands and feet. Increased blood sugar can cause nerve damage, also known as neuropathy.
Frequent yeast infections. High blood sugar can be fuel for natural yeast in your body allowing yeast to grow in moist areas like your mouth, throat, armpits, or genital area.
Do you have one or more of the symptoms described above? If you do, it is best to visit your health care provider to discuss your symptoms and possibly get a blood test for high glucose levels. If you are over 40 years old and have siblings with diabetes (even if you don’t have symptoms), you should get routine blood glucose checks.
The blood test will tell you if you have normal levels of glucose in your blood. If your blood glucose level is higher or lower than what is considered normal, you could have diabetes. Because everyone is unique, normal blood glucose levels are slightly different for everyone. The good news is there are general guidelines for normal blood glucose levels.
In the US, blood glucose is measured in milligrams per deciliter (mg/dL), and guidelines for blood glucose concentration are determined generally before and after you have had a meal. Your blood glucose level two hours after a meal should be less than 180 mg/dL. Blood glucose levels before a meal (fasting blood sugar) should be between 80 and 130 mg/dL.
If your test shows a blood glucose level above 125 mg/dL, you will be asked to repeat the test on another day to help confirm a diabetes diagnosis. Your health care provider may also order an A1c test that measures your average blood sugar level over the past three months. The A1c test gives you a better idea of your blood sugar over time. Normal A1c level ranges from 4.5 to 5.6 percent for someone who doesn’t have diabetes. An A1c level over 6.4 percent on two separate tests indicates you have diabetes.
What Happens After Diabetes Diagnosis?
The earlier diabetes is diagnosed, the sooner treatment can begin. Untreated diabetes can cause damage to many parts of your body like your blood vessels, heart, eyes, and kidneys. In fact, untreated diabetes affects most parts of your body in some way. That sounds scary, but the good news is that diabetes is treatable.
Diabetes is treated with medications and lifestyle modifications. People who live with type 1 diabetes need insulin, while people with type 2 diabetes may need insulin or other types of medicine. People with prediabetes, gestational diabetes, and some people with type 2 diabetes can often manage the condition through lifestyle adjustments like healthy eating and exercise.
If you have some of the symptoms of diabetes, you have taken an important first step by seeking information about diabetes. You may have diabetes, another health concern, or nothing at all. Discuss your symptoms with your healthcare provider. If you do have diabetes it is important to get treatment to avoid future health complications. With proper treatment, you can live a healthy life with diabetes!